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6 September 2019

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How can I create good relationships between my PCN’s member practices?

Our panel of experts tackle the difficult issues that steal your time. Compiled by Kaye McIntosh

One GP partner is very hostile in Primary Care Network (PCN) meetings and is reluctant to work with other practices. Is there anything I can do to help?

Kay Keane advises:

Have they seen it all before? Are they negative about PCNs or general practice overall? It’s an interesting situation but one that many of us see all too often. It’s not just GPs, of course, it could be a PM colleague or another professional who is displaying negativity.

It would be interesting to understand the root of the issue. A conversation on the side between the negative person and you or the clinical director is a good way to address this.

Sometimes negativity is a sign of burnout, or it might be that they don’t understand how their attitude is affecting everyone else. It may be a difficult conversation but done with kindness it should help the GP understand the impact of their dissatisfaction and reveal any underlying problems.

Kay Keane is PM at the Alvanley Family Practice in Stockport, Greater Manchester

Nick Nurden says:

A confrontational approach is unlikely to help in the meetings – it would be best dealt with outside. First, it may be worth talking to the hostile partner to try and understand their viewpoint and help them realise the impact on the rest of the group.

Carefully consider who the best person is to have this conversation – there may be someone else in the network who they see as friendly. If that doesn’t work, you could approach another partner in the difficult GP’s practice.

Understanding why they are behaving badly may provide an opportunity to channel their energy. If they were given a role or project within the network, especially in an area about which they are passionate, then this may help them to see the benefits of the PCN.

In the end, it is important for all of us to make this opportunity work for our local communities. If hostility persists then eventually you may have to consider more formal action, which would be a shame. Your network contract and associated schedules should support you here. If you don’t already have it in place, do consider creating guidance on how members should behave with each other.

Nick Nurden is the business manager and a partner at The Ridge Medical Practice in
Bradford, West Yorkshire

Daniel Vincent recommends:

From experience, I would say this is something that is best dealt with using an external facilitator, as you have to maintain a working relationship with the person. A facilitator could host a routine meeting to observe the problem and then discuss it with the person.

There is the possibility that the difficult GP will be on best behaviour when a third party is present. Ask the clinical director to agree that, if this happens, they should have a chat with this GP after the meeting. They could explain that they had noticed a real difference in behaviour and give examples of how much more productive the session was. Either way, there needs to be some brave and bold action. 

Daniel is PM and Managing Partner at Ryalls Park Medical Centre, Yeovil, Somerset